临床路径对我国脑梗死患者住院时间、费用及护理满意度影响的Meta分析

Influence of clinical pathway on length and cost of hospital stay,nurse satisfaction for patients with cerebral infarction:a Meta-analysis

目的:运用循证医学Meta分析方法探讨护理临床路径对我国脑梗死患者住院时间、费用及满意度的影响。方法:采用主题词结合自由词原则,电子检索国内中文数据库收集相关文献,根据纳入标准筛选文献并提取数据,采用STATA 12.0软件进行Meta分析,计算标准均数差(standard mean difference,SMD)或优势比(odds ratio,OR)及其95%可信区间(95%confidence intervals,95%CI)评价临床路径对我国脑梗死患者住院时间、费用及护理满意度的具体影响。结果:本研究共计纳入8项临床对照研究,包括1 622例脑梗死患者,其中临床路径组824例,常规护理组798例。Meta分析结果显示,临床路径组患者平均住院时间(SMD=-1.00,95%CI=-1.31^-0.70,P<0.001)、平均住院费用(SMD=-1.72,95%CI=-3.13^-0.31,P=0.020)及护理满意度(OR=7.15,95%CI=1.26~40.64,P=0.030)均优于常规护理组。结论:脑梗死患者实施护理临床路径可能会缩短住院时间、降低住院费用,并可能提高患者的护理满意度。

Objective： To investigate the influence of clinical pathway for patients with cerebral infarction（ CI） on nursing satisfaction,length and cost of hospital stay by Meta-analysis. Methods： Data collection of relevant clinical controlled trials were extensively selected from Chinese databases. Meta-analysis was conducted by STATA 12. 0 software. Crude standard mean difference（ SMD） or odds ratio（ OR） with their 95% confidence interval（ CI） were calculated. Results： According to inclusion criteria,8 case-control studies were assessed with a total of 1 622 cerebral infarction patients,including 824 patients in the observation group and 798 patients in the control group. Meta-analysis showed that clinical pathway may shorten length of stay（ SMD =-1. 00,95% CI =-1. 31--0. 70, P〈0. 001）,reduce the hospital cost（ SMD =-1. 72,95% CI =-3. 13--0. 31,P = 0. 020）,and improve nurse satisfaction of patients（ OR = 7. 15,95% CI = 1. 26-40. 64,P = 0. 030）. Conclusion： The present Meta-analysis indicates that clinical pathway may significantly reduce length and cost of hospital stay and improve nursing satisfaction for cerebral infarction patients.